Ewing Sarcoma Arising After Treatment of Diffuse Large B-cell Lymphoma
Ewing Sarcoma Arising After Treatment of Diffuse Large B-cell Lymphoma
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DOI：
10.1093/jjco/hyt011
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发表时间：
2013-04-01
影响因子：
2.4
通讯作者：
Tobinai, Kensei
中科院分区：
文献类型：
--
作者：
Hiramoto, Nobuhiro;Kobayashi, Yukio;Tobinai, Kensei
我们报告的情况下，病人中的尤文肉瘤的诊断产生的软组织后，成功治疗弥漫性大B细胞淋巴瘤。一位65岁女性，在接受环磷酰胺、盐酸羟基柔红霉素、长春新碱、泼尼松龙方案成功治疗弥漫性大B细胞淋巴瘤8年后，出现左肩胛区快速增长的肿块。胸部的计算机断层扫描检查和磁共振成像显示左肩胛区有一个40毫米大小的肌内肿瘤。开放活检标本的组织学检查显示一个小圆细胞肿瘤，显示CD 99阳性染色。荧光原位杂交显示分裂信号的EWS基因在染色体22 q12的分裂探针。逆转录-聚合酶链反应证实EWS-FLI 1融合转录本的表达。基于这些发现，患者被诊断为继发性尤文肉瘤。尽管辅助化疗，然而，她死于肺转移2年后诊断尤文肉瘤。治疗相关的血液系统恶性肿瘤与平衡易位先前已报告。一种与继发性恶性肿瘤的发生机制相似的机制可能解释这种实体癌的发生。
We report the case of a patient in whom the diagnosis of Ewing sarcoma arising from a soft tissue was made after successful treatment of diffuse large B-cell lymphoma. A 65-year-old woman presented with a rapidly growing mass in her left scapular region 8 years after successful chemotherapy with the cyclophosphamide, hydroxydaunomycin hydrochloride, vincristine, prednisolone regimen for diffuse large B-cell lymphoma. Computed tomographic examination and magnetic resonance imaging of the thorax revealed an intramuscular tumour measuring 40 mm in size in the left scapular region. Histopathological examination of an open biopsy specimen revealed a small round cell tumour that showed positive staining for CD99. Fluorescence in situ hybridization showed a split signal by a break-apart probe for the EWS gene in chromosome 22q12. Reverse transcriptase-polymerase chain reaction confirmed the expression of EWS-FLI1 fusion transcripts. Based on these findings, the patient was diagnosed as having secondary Ewing sarcoma. Despite adjuvant chemotherapy, however, she died of pulmonary metastases 2 years after the diagnosis of Ewing sarcoma. Therapy-related haematological malignancies with balanced translocations have been reported previously. A mechanism similar to that underlying the development of secondary malignancy might explain the occurrence of this solid cancer.